Provider Demographics
NPI:1043710825
Name:COKER, ROSALIND DENISE
Entity Type:Individual
Prefix:
First Name:ROSALIND
Middle Name:DENISE
Last Name:COKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 DONNELL AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63137-1611
Mailing Address - Country:US
Mailing Address - Phone:314-580-9710
Mailing Address - Fax:314-733-5415
Practice Address - Street 1:1001 DONNELL AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63137-1611
Practice Address - Country:US
Practice Address - Phone:314-580-9710
Practice Address - Fax:314-733-5415
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-18
Last Update Date:2018-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care